Document Detail


Dominant effect of histocompatibility on ten-year kidney transplant survival.
MedLine Citation:
PMID:  3278435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Using actuarial methods, factors influencing long-term graft survival were examined in 33,594 recent (since 1974) kidney transplants reported to the University of California, Los Angeles, Transplant Registry. One- and 10-year graft-survival rates as well as late (from 3 through 10 years) graft-loss rates (half-lives) were determined. The donor-recipient relationship had the greatest influence on long-term graft survival. Transplants between HLA-identical siblings had graft-survival rates of 89% at 1 year and 68% at 10 years, compared with 76% and 43% for parental donors, and 58% and 26% for cadaver donor transplants, respectively. These differences were also evident from the graft half-lives, which were 22 years for HLA-identical sibling, 12 years for parental, and 8 years for cadaver donor allografts. In cadaver donor transplants, matching for HLA-A,B antigens had the greatest influence on long-term graft survival, with a 15% 10-year graft survival (39% vs. 24%) and 7-year half-life (14 vs. 7 years) advantage seen with the best (zero HLA-A,B mismatches) compared with the worst (4 HLA-A,B) cases, respectively. Some of the factors studied, such as transplant number and pretransplant transfusions, tended to influence the short- rather than long-term graft-survival rates. Others, including HLA-A,B matching, early graft function and the recipient's original disease, influenced both early and late graft survival. Over all, histocompatibility between donor and recipient had by far the greatest influence on the long-term success of renal allografts.
Authors:
H Takiff; D J Cook; N S Himaya; M R Mickey; P I Terasaki
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Transplantation     Volume:  45     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  1988 Feb 
Date Detail:
Created Date:  1988-03-29     Completed Date:  1988-03-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  410-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, School of Medicine, University of California, Los Angeles 90024.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adolescent
Adult
Age Factors
Blood Transfusion
Cadaver
Child
Child, Preschool
Combined Modality Therapy
Diabetic Nephropathies / mortality
Family
Female
Graft Survival*
HLA Antigens / analysis
HLA-A Antigens
HLA-B Antigens
Histocompatibility*
Humans
Infant
Infant, Newborn
Kidney / physiology
Kidney Transplantation*
Longevity*
Male
Middle Aged
Organ Preservation
Postoperative Period
Risk Factors
Tissue Donors
Grant Support
ID/Acronym/Agency:
AM02375/AM/NIADDK NIH HHS; CA09120/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/HLA Antigens; 0/HLA-A Antigens; 0/HLA-B Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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